HomeMy WebLinkAbout11-4127
,Y
PERINI SERVICES/ IN THE COURT OF COMMON PLEAS OF
SOUTH HAMPTON MANOR, L.P.: CUMBERLAND COUNTY, PENNSYLVANIA
Plaintiff
V NO. 2011- L41 CIVIL TERM
. c ?
W
CAROLYN D. MARTIN, r-i = =-n
Individually and as agent ern ?• ?-
.
for Ruth V. Martin 1 =6o
Defendant r M w ° c:,
NOTICE W
You have been sued in court. If you wish to defend against the claims set forth in the
following pages, you must take action within twenty (20) days after this complaint and notice are
served, by entering a written appearance personally or by an attorney and filing in writing with
the court, your defenses or objections to the claims set forth against you. You are warned that if
you fail to do so, the case may proceed without you and a judgment may be entered against you
by the court without further notice for any money claimed in the complaint or for any other claim
or relief requested by the plaintiff. You may lose money or property or other rights important to
you.
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO
NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE
OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP.
Cumberland County Bar Association
32 South Bedford Street
Carlisle, Pennsylvania 17013
(717) 249-3166
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PERINI SERVICES/
SOUTH HAMPTON MANOR, L.P.
Plaintiff
V.
CAROLYN D. MARTIN,
Individually and as agent
for Ruth V. Martin
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 2011 -
CIVIL TERM
COMPLAINT
NOW, comes Perini Services/South Hampton Manor Limited Partnership d/b/a
Shippensburg Health Care Center ("Shippensburg Health"), by and through its attorneys, BARIC
SCHERER, and files the within Complaint and, in support thereof, sets forth the following:
Shippensburg Health is a Maryland limited partnership duly authorized to conduct
business in the Commonwealth of Pennsylvania with a business address of 121 Walnut Bottom
Road, Shippensburg, Cumberland County, Pennsylvania 17257.
2. Defendant, Carolyn D. Martin, is an adult individual with a residence address of
342 Wayne Avenue, Chambersburg, Franklin County, Pennsylvania 17201.
3. Shippensburg Health operates a resident skilled care nursing facility located at
121 Walnut Bottom Road, Shippensburg, Cumberland County, Pennsylvania 17257.
4. On or about September 16, 2010, Ruth V. Martin sought to be admitted to the
Shippensburg Health facility.
5. On or about September 16, 2010, Carolyn D. Martin as attorney-in-fact for Ruth
V. Martin, executed an Admission Agreement on behalf of Ruth V. Martin at the facility. A true
and correct copy of the Admission Agreement is attached hereto as Exhibit "A" and is
incorporated.
6. Pursuant to the Admission Agreement, Ruth V. Martin would be responsible to
pay any costs of care which were not covered by a third party payer.
7. On or about September 16, 2010, Ruth V. Martin became a resident of the
Shippensburg Health facility and remained a resident until her passing on March 7, 2011.
8. Pursuant to the Admission Agreement, Carolyn D. Martin agreed, as the
responsible party for Ruth V. Martin, to pay the costs of care provided from the income of Ruth
V. Martin.
9. As of March 7, 2011, Ruth V. Martin owed Shippensburg Health the sum of
$4,413.30 for the costs of care provided by Shippensburg Health to her. A true and correct copy
of the Statement reflecting the balance due is attached hereto as Exhibit "B" and is incorporated.
10. Demand has been made upon Carolyn D. Martin to pay the amount due for the
costs of care provided to Ruth V. Martin.
COUNT I-BREACH OF CONTRACT
SHIPPENSBURG HEALTH v. CAROLYN D. MARTIN
11. Plaintiff incorporates by reference paragraphs one through ten as though set forth
at length.
12. Carolyn D. Martin has breached his obligation to pay for the costs of care
provided to Ruth V. Martin from the income and assets of Ruth V. Martin.
13. As a consequence of that breach, Shippensburg Health is owed the sum of
$4,413.30 to March 7, 2011.
14. The accrued debt consists of the private pay obligation of Ruth V. Martin.
Carolyn D. Martin has failed to pay the private pay obligation from the benefits she has received
in the name of Ruth V. Martin.
15. The Admission Agreement bound Ruth V. Martin to pay for the costs of her care
at the facility and bound Carolyn D. Martin to pay the costs of care from the assets and income of
Ruth V. Martin.
16. The Admission Agreement provides for the recovery of a penalty for late
payments in the amount of 1.5% per month.
17. The Admission Agreement provides for the recovery of reasonable attorney fees
and costs incurred by Shippensburg Health to collect a debt due and owing to Shippensburg
Health.
WHEREFORE, Plaintiff requests judgment in its favor and against Carolyn D. Martin for
the sum of $4,413.40 plus additional interest, costs and expenses and any additional amount
coming due to the date of award and attorney fees and costs.
Respectfully submitted,
BARIC SCHERER
A,- z
David A. Baric, Esquire
I.D. # 44853
19 West South Street
Carlisle, Pennsylvania 17013
(717) 249-6873
Attorney for Plaintiff
dab.d it/shcc/martin-ruth/complaint. pld
VERIFICATION
The statements in the foregoing Complaint are based upon information which has been
assembled by my attorney in this litigation. The language of the statements is not my own. I
have read the statements; and to the extent that they are based upon information which I have
given to my counsel, they are true and correct to the best of my knowledge, information and
belief. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. §
4904 relating to unsworn falsifications to authorities.
DATE: L wo?(Lxnnm
Allison Klimowicz
Corporate Operations Center Director
n
SHIPPENSS.URG HEALTH CARE CENTER
ADMISSION AGREEMENT
THIS AGREEMENT, made this I( day of 6w
A.D., by and between SHIPPENSBURG HEALTH CARE CENTER (hereafter
"SHIPPENSBURG") and h
(hereafter "Resident"), previously residing at (Street Address and Post office
Box)
and
(hereafter
"Legal Representative"), residing at (Street Address and Post Office Box)
I. PROVISION OF SERVI_ _CEs
A. NURSING SERVICES: SHIPPENSBURG will provide the Resident with
routine nursing services, semi-private accommodations, three meals each day
(except as otherwise medically indicated), blankets, bed linens, towels and
wash cloths, laundering of blankets, linens, towels, and wash cloths,
housekeeping services, and activity programs and social services as
established by 'the facility, as identified on the Rate Schedule. The Rate
Schedule is attached to this Agreement and is incorporated herein as if set forth
in full. The Rate Schedule sets forth the list of supplies and services included in
SHIPPENSBURG's daily rates, those supplies and services which are not
covered by the daily rates for which the Resident will be separately charged,
9
EXHIBIT "A"
The staff of SHIPPENSBURG will take whatever time is necessary to answer
ail of your questions. Please continue to ask questions
until you are sure that you understand.
and those supplies and services covered by the Medicare and/or Medicaid
programs for enrolled. Residents.
Federal and state laws and regulations dhange regularly and frequently
require changes related to the care and services SHIPPENSBURG provides.
Additionally, other financial factors may require SHIPPENSBURG to make
changes related to provision of its care and services. On this basis, the Rate
Schedule may be changed, upon notice to the resident.
B. ANCILLARY SERVICES AND SUPPLIES: SHIPPENSBURG will also
provide ancillary services and supplies as set forth in the Rate Schedule, and
private accommodations upon the direction of the Resident's physician. The
ancillary services and supplies are subject to change from time to time at the
discretion of SHIPPENSBURG.
C. OUTSIDE PROVIDERS AND NON-FACILITY SERVICES:
SHIPPENSBURG makes available, from time to time, the services of outside
providers and non-facility services. These services will be available under
SHiPPENSBURG's policies and procedures, and at the Resident's sole
expense unless the charges for such services are covered by a third party
payer. Should the Resident arrange for the services of outside providers, the
providers must be properly licensed or registered under state and federal law,
and must comply with all SHIPPENSBURG policies and procedures, including,
but not limited to, providing SHIPPENSBURG with documented proof of their
legally required liability insurance coverage. All outside providers must be
approved in writing by SHIPPENSBURG before providing any services, At
SHiPPENSBURG's sole discretion, only providers deemed by
SHIPPENSBURG to fulfill all of the requirements set forth in federal and state
law, as well as SHiPPENSBURG's policies and procedures, may provide
services to Residents.
The Resident recognizes and agrees that all outside providers, including
those designated by SHIPPENSBURG, are independent contractors. The
Resident recognizes and agrees that such providers are not associates or
agents of SHIPPENSBURG, and that SHIPPENSBURG is not liable for any
outside provider's acts or omissions. The Resident shall be solely responsible
for payment of all charges of any provider who renders care to the Resident in
SHIPPENSBURG,. unless the charges are covered by a third party payer.
Furthermore, the Resident agrees to confirm that any Resident initiated,
approved outside provider (i.e. private duty nurse, etc.) has worker's
compensation Insurance coverage as required by law, as well as liability
insurance. To the extent that the outside provider does not have the legally
required worker's compensation insurance coverage, the Resident will provide
and pay for such coverage.
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if. RESIDENT'S RIGHTS
SHIPPENSBURG welcomes all persons in need of its services
and does not discriminate on the basis of age, disability, race, color,
national origin, ancestry, religion, or sex. Furthermore, SHIPPENSBURG does
notdiscriminate among persons based on their sources of payment.
A. Consent for Treatment
1. SHIPPEfl1SBURG SERVICES: By signing this Agreement,
the Resident consents to SHIPPENSBURG providing routine nursing and other
health care services and administering all medication as directed by the
attending physician, or when the attending physician is unavailable,
SHIPPENSBURG s Medical Director. SHIPPENSBURG is not obligated to
provide the Resident with any medications, treatments, special diets or
equipment without specific orders or directions from the Resident's physician or
SHIPPENSBURG's Medical Director. From time to time SHIPPENSBURG may
participate in training programs for persons seeking licensure or certification as
health care workers. In the course of this participation, care may be rendered
to the Resident by such trainees under supervision as required by law.
Consent to routine nursing care provided by SHIPPENSBURG shall include
consent for care by such trainees.
2. PHYSICIAN SERVICES: The Resident acknowledges that
he or she is under the medical care of a personal attending physician, and that
SHIPPENSBURG provides services based on the general and specific
instructions of that physician, or when unavailable, SHIPPENSBURG's Medical
Director. The Resident has a right to select his or her own attending physician.
if, however, the Resident does not select an attending physician, or is unable to
select an attending physician, an attending physician may be designated by
SHIPPENSBURG or in accordance with state law. All attending physicians
must meet and conform with all of SHIPPENSBURG's policies and procedures,
and are subject to the terms set forth in the Outside Providers and Non-facility
Services section of this Agreement.
3. - RIGHT TO REFUSE TREATMENT: The Resident has the
right to refuse treatment and to revoke consent for treatment. The Resident
also has the right to be Informed of the medical consequences of such refusal
or revocation of consent, and to be informed of alternate treatments available.
Where, in the opinion of the attending physician or by judgment of a court of
law, the Resident is determined to be mentally incompetent to make a decision
regarding refusal of treatment, the decision to refuse treatment may be made by
a Legal Representative or other surrogate decision-maker, subject to state and
federal law.
3
B. Resident's Personal Property
SHIPPENSBURG strongly discourages the keeping of valuable jewelry,
papers, large sums of morie?, or other Items considered of value in
SHIPPENSBURG. However, the Resident shall be permitted to retain and use
personal clothing and possessions as space permits, unless to do so would
infringe upon the right of other residents or unless determined medically
inadvisable as documented by the Resident's physician in the Resident's
medical record. SHIPPENSBURG shall make reasonable efforts to properly
handle and safeguard the Resident's personal property in SHIPPENSBURG.
The Resident agrees to inform SHIPPENSBURG of all valuable property upon
admission. If, at any time during the Resident's stay, new items of value are
added to the Resident's possessions in SHIPPENSBURG, the Resident agrees
to so inform SHiPPENSBURG's Administrator or designee.
The Resident is responsible for obtaining at his or her own expense any
insurance coverage necessary to cover potential damage to or loss of any of
Resident's personal property. SHIPPENSBURG shall not be liable for damage
to or loss of any of Resident's personal property. Should the Resident lose his
or her property, or believe that his or her property has been otherwise removed
from his or her possession, the Resident agrees to follow SHIPPENSBURG's
procedure for filing reports of lost or stolen property.
In the event that Resident is transferred or discharged from
SHIPPENSBURG, or if the Resident expires, the Resident hereby authorizes
SHIPPENSBURG to transfer the Resident's personal property to the Resident's
Legal Representative, or to any duly authorized representative of Resident's
estate. If the Resident's personal property is not claimed or removed within
twenty-four (24) hours of the Resident's transfer or discharge, or expiration, the
Resident authorizes SHIPPENSBURG to place his personal property into
storage until claimed. Standard daily storage charges will continue while the
Resident's property remains in SHIPPENSBURG.
Should the Resident's property fall to be claimed within fourteen (14)
days of the Resident's transfer, discharge, or expiration, the Resident and
SHIPPENSBURG hereby agree to a storage and sale arrangement. Under this
arrangement, SHIPPENSBURG agrees to bear any and all costs of the storage
of the Resident's property, not including any insurance thereon. However, in
consideration of SHiPPENSBURG's storage of the Resident's property, should
the Resident's property fall to be claimed within thirty (30) days of placement by
SHIPPENSBURG into storage, the Resident hereby agrees that
SHIPPENSBURG may dispose of the Resident's property with and at
SHiPPENSBURG's discretion, including retaining all proceeds from any sale
thereof.
4
C. Resident's Records
1. CONFIDENTIALITY: information included in the Resident's
medical records is confidential. Unauthorized persons shall not be allowed to
review these records without the Resident's written consent, except as required
or permitted by law.
2. CONSENT TO RELEASE BY SHIPPEhlSBURG; The Resident
authorizes SHIPPENSBURG to release all or any part of the Resident's medical
or financial records to any person or entity which has or may have a legal or
contractual obligation to provide the Resident with medical services, or to pay
all or a portion of the costs of care provided to the Resident, including but not
limited to hospital or. medical services companies, insurance companies,
workers' compensation carriers, welfare funds, and/or the Resident's employer.
The Resident also authorizes' release of information from medical or financial
records to any medical professional or institution responsible for the Resident's
medical or nursing care when the Resident is transferred or discharged from
SHIPPENSBURG. The Resident hereby releases SHIPPENSBURG from any
liability for damages or other loss suffered in or incurred by the Resident and
arising out of or directly or indirectly related to the reliance by the facility upon
the foregoing authorization.
3. PHOTOGRAPH&; The Resident authorizes SHIPPENSBURG to rr
photograph or videotape the Resident as a means of identification or for health
related purposes. The photographs or videotapes may.also be used to help
locate the Resident in the event of an unauthorized absence from
SHIPPENSBURG, but shall otherwise be kept confidential. If SHIPPENSBURG
intends to use the photograph or videotape for purposes other than those noted
above, SHIPPENSBURG shall get written permission from the Resident in
advance of such use (SHIPPENSBURG sometimes requests Resident to permit
the use of their photograph and written impressions about SHIPPENSBURG in
marketing and other public Information materials). The Resident retains the
right to refuse the taking of a photograph at any particular time.
5
D, RESIDENT'S RESPONSIBIL.ITiES
1. RULES AND REWLATIONS: The Resident agrees that
SHIPPENSBURG may, to maintain orderly and economical operations, adopt
reasonable rules and regulations to govern the conduct and responsibilities of
the Resident. These rules and regulations Include that SHIPPENSBURG is a
SMOKE FREE' CAMPUS, with no smoking or use of smokeless tobacco
products permitted in all its buildings, grounds and parking areas, for new
residents, their visitors, staff, vendors, physicians, contractors, and volunteers.
The Resident agrees to follow those rules and regulations. It is understood that
these rules and regulations may be amended from time to time as
SHIPPENSBURG may require. Any changes to the rules and regulations shall
be given to the Resident in writing. NOTE: Some residents admitted prior to the
effective date of the SMOKE FREE CAMPUS Policy will be allowed to continue
smoking in special designated areas as required by Federal regulations.
2. DIET: The Resident understands that his or her diet is medically
prescribed and, therefore, must be monitored by SHIPPENSBURG. The
Resident agrees to consult with Nursing or Dietary staff when food or
beverages are brought into SHIPPENSBURG.
3. MEDICATIONS: No medications or drugs may be brought upon
SHIPPENSBURG premises unless the medications or drugs are labeled
according to the requirements of state and federal taw. Packaging of
medications must be compatible with SHIPPENSBURG's medication
distribution system. No drugs or medications may be brought into
SHIPPENSBURG unless they are delivered directly to the nurses' station.
4. CARE OF SHIPPENSBURG'S PROPERTY: To preserve the
value of SHIPPENSBURG's property for future residents' use, the Resident
agrees to use due care to avoid damaging SHIPPENSBURG`s property and
premises. The Resident shall be responsible for the costs of repair or
replacement of SHIPPENSBURG's property damaged or destroyed by the
Resident. However, the Resident shall not be responsible for such damage as
is to be expected from ordinary wear and tear.
5. CARE OF THE RESIpENT'S ROOM; SHIPPENSBURG
encourages the Resident to have a SHIPPENSBURG-like environment, and will
attempt to accommodate 'all reasonable requests to individualize resident
rooms. For safety reasons, SHIPPENSBURG must approve any addition or
rearrangement of furniture, hanging of pictures, posters, or other similar
activities.
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6. INDEMNIFICATION: The Resident hereby agrees to Indemnify
and hold harmless SHIPPENSBURG, its officers, directors, agents, and
employees from and against any and all claims, demands or causes of action
for injury or death to - person or damage to property, including all costs and
attorneys fees incurred in defending any claim, demand or cause of action
which is caused by the Resident and which is not caused by any willful or
negligent action of SHIPPENSBURG. This indemnification Includes, but is not
limited to, all claims, demands or causes of action stemming from the acts or
omissions of the Resident, including but not limited to Resident's refusal of any
nursing care, medical or other treatment, or any other item or service deemed
necessary by SHIPPENSBURG or any other treating health professional.
Ill. POLICY REGARDING THE IMPLEMENTATION
OF THE PATIENT SELF-DETERMINATION ACT
The following information is being provided to the Resident as a result of
a federal law which requires certain health care institutions, including
SHIPPENSBURG, to disclose to the Resident his or her rights under federal
and state law to make decisions regarding his or her health care.
A. INTRODUCTION.
1. SHIPPENSBURG recognizes and appreciates the dignity and value
of each Resident's life, and the right of each Resident to make decisions
regarding his or her care.
2. SHIPPENSBURG recognizes the Resident's right to have these
decisions made on his/her behalf by a substitute decision-maker in accordance
with state law when the Resident is no longer able to make them.
3. SHIPPENSBURG recognizes the right of each Resident to utilize
those health care advance directives recognized under state law, and will honor
such advance directives developed and implemented in accordance with state
law and consistent with the level of care SHIPPENSBURG is licensed to
provide, A health care advance directive is a written document that states
choices for health care and/or names or precludes those individuals who the
Resident wishes to make those choices. These choices may include the refusal
of certain types of care. A Living Will and a Durable Power of Attorney for
Health Care are examples of such advance directives.
7
PENNSYLVANIA LAW PERMITS SHIPPENSBURG TO REFUSE TO
HONOR DECISIONS BY THE INDIVIDUAL YOU APPOINT AS YOUR
AGENT IN AN ADVANCE DIRECTIVE OR BY A "HEALTH CARE
REPRESENTATIVE" WHO SEEKS TO MAKE SUCH DECISIONS FOR
YOU UNDER PENNSYLVANIA LAW IF SHIPPENSBURG HAS A GOOD
FAITH BELIEF THAT THE INDIVIDUAL IS NOT REALLY AUTHORIZED
TO MAKE DECISIONS FOR YOU UNDER THE LAW OR THAT THE
DECISIONS BEING MADE ARE NOT CONSISTENT WITH THE RULES
FOR SUCH INDIVIDUALS TO MAKE DECISIONS ON YOUR BEHALF
ESTABLISHED BY PENNSYLVANIA LAW,
BvHEALTHCARE ADVANCE DIRECTIVE. A health care advance
.. «v .vvpYVVV Gil
made apart of his or her medical record it is essential that SHIPPENSBURG
ro.+elVCa v?lirllvavee.ii..I .. .L.:_--- _-
rein.
RECENT CHANGES IN PENNSYLVANIA LAW (discussed further below
in Subsection C) PROVIDE SOME ADDITIONAL REASONS TO
CONSIDER HAVING AN ADVANCE DIRECTIVE,
WHILE SHIPPENSBURG WILL REQUIRE A "HEALTH CARE
REPRESENATIVES" TO CERTIFY THAT THEY HAVE KNOWLEDGE
OF THE INCAPACITATED PERSON'S PREFERENCES, VALUES,
AND MORAL AND RELIGIOUS BELIEFS, THE LAW PERMITS THEM
TO MAKE SOME DECISIONS BASED ON THEIR OWN EVALUATION
OF THE INFORMATION ABOUT THE INCAPACITATED PERSON'S
CONDITION WHERE INSTRUCTIONS FROM THE INCAPACITATED
PERSON IS LACKING.
8
C. HEALTH CARE REPRESENTATIVE. PENNSYLVANIA LAW PERMITS
AN INDIVIDUAL QUALIFYING AS A "HEALTH CARE REPRESENTATIVE"
UNDER 20 PA. C.S. § 5461 TO MAKE HEALTH CARE DECISIONS FOR
INCAPACITATED PERSONS, WHO HAVE AN END-STAGE MEDICAL
CONDITION OR ARE PERMANENTLY UNCONSCIOUS. WiT14M iT TUA-T
AN ADVANCE DIRECTIVE CAN PROVIDE SPECIFIC INSTRUCTIONS
FOR AND ALSO LIMIT WHO CAN QUALIFY AS A "HEALTH CARE
REPRESENTATIVE" OR CAN PROVIDE THEM WITH ADDITIONAL
AUTHORITY TO ACT ON ONE'S BEHALF. IF A RESIDENT WISHES
TO PLACE SUCH LIMITS ON THE ABILITY OF OTHERS TO ACT AS
THEIR "HEALTH CARE REPRESENTATIVE" OR TO PROVIDE
ADDITIONAL INSTRUCTIONS FOR THEM, THE RESIDENT SHOULD
CONSIDER HAVING A WRITTEN ADVANCE DIRECTIVE THAT
STATES THEIR WISHES; AND, THE RESIDENT MAY WISH TO
CONSULT WITH THEIR FAMILY AND LEGAL COUNSEL ON THIS
QUESTION.
D. ASSISTANCE AVAILABLE,
9. Questions about SHIPPENSBURG's policies regarding health care
decision-making and/or advance directives may be presented to
SHIPPENSBURG's Administrator.
2. Questions regarding whether and how to execute health care
advance directives and about their content should be discussed with the
Resident's family, physician and attorney.
3. SAMPLE HEALTH CARE ADVANCE DIRECTIVE tzr
lncluded in the ourrent Pennsylvania Livinq Will Statute accompanies this
Agreement for the Resident's information.
4. Resident should consult with their family, physician, and
attorney before using any Advance Directive Forms.
9
iV. CAPACITY OF ESIDENT AND GUARDI NSHiP
If the Resident Is or becomes unable to understand or communicate, and
is determined to be incapacitated by the Resident's physician, in the absence of
the Resident's prior designation of an authorized Legal Representative, or upon
the unwillingness or inability of the Legal Representative to act,
SHIPPENSBURG shall have the right to commence a legal proceeding to
adjudicate the Resident incapacitated. As a result of such a legal proceeding
SHIPPENSBURG shall have a court appoint a legal guardian for the Resident.
SHIPPENSBURG also shall have the right to commence a legal proceeding to
have a court replace an authorized Legai Representative with a new one or with
a legal guardian when SHIPPENSBURG has a good faith belief that the Legal
Representative is. not acting in the best interests of the Resident. The cost of
the legal proceedings, including attorney's fees and costs, if not covered by the
Commonwealth, shall be paid promptly by the Resident or the Resident's
estate.
V. FINANCIAL ASPECTS OF THE AGREEIUIENT
A. Legal Representative
1. STATUS. While not legally required, if the Resident is unable to make
decisions for himself or herself, a Legal Representative should be available to
make certain .decisions 'on behalf of the Resident. For the purposes of this
Agreement, the Resident's Legal Representative is the person selected by the
Resident and defined under state and federal law as the Resident's responsible
person, or as the person recognized under state law as having the authority to
make health care and/or financial decisions for the Resident, The Legal
Representative may or may not be court appointed, may be an attorney-In-fact
acting under a durable power of attorney for health care, guardian, conservator,
next-of-kin, or other person allowed to act for the Resident under state law. if
Legal Representative status has been conferred by a court of law or through
appointment by the Resident, verification of such status must be provided to
SHIPPENSBURG at the time of Admission. Such verification includes providing
SHIPPENSBURG with a certified copy of any court order, or a validly executed
original Power of Attorney or other legal document.
10
2. REQUIREMENTS. For purposes of this Agreement, LEGAL
'REPRESENTATIVES ARE REQUIRED TO SIGN THIS AGREEMENT FOR
ADMISSION, AND AGREE TO DISTRIBUTE TO SHIPPENSBURG, FROM
THE RESIDENT'S INCOME OR RESOURCES, PAYMENT WHEN DUE FOR
ITEMS/SERVICES PROVIDED TO THE RESIDENT. Legal Representative is
contractually bound by the terms of this Agreement and may become personally
liable for failure to perform their fiduciary duties under the Agreement. Legal
Representatives are also required to produce financial documentation as proof
of the Resident's ability to pay for charges when due. Wherever this
Agreement refers to the Resident's financial obligations under this
Agreement, the term "Resident" shall be construed to Include the
obligations of any Legal Representative to act on behalf of Resident.
E. Financial-Arran ements
1. INCOME AND ASSETS/ CHAN ES TO INCOME AND ASSETS: It
is essential that the Resident advise SHIPPENSBURG of the Resident's
income and assets, and to communicate changes in the Resident's income or
assets to SHIPPENSBURG as quickly as possible. The Resident hereby
agrees to notify SHIPPENSBURG ninety (90) days prior to the time when the
Resident has reason to believe that his income and assets will no longer be
sufficient to fulfill his financial obligations under the terms of this Agreement.
2. MEDICAL, ASSISTANCE. Generally, when private funds are
depleted, residents apply for Medical Assistance benefits under Title XIX of the
Social Security Act and Article IV of the Pennsylvania Public Welfare Code.
The Medical Assistance application process can be complicated, and the
processing time can be lengthy. SHIPPENSBURG is experienced in the
Medical Assistance Application process, and can be of great assistance to the
Resident in this process, To be of assistance, SHIPPENSBURG must have
accurate record of the history and depletion of the Resident's income and
significant assets.
3. DISCLOSURE FORM. On this basis, please set forth the
Resident's income and assets below:
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So fal Seaurft :
Account Number:
Monthly Income:
Payee:
Pension:
Account Number:
Monthly Income:
Financial Institution:
Payee:
Trusts:
Account Number(s):
Monthly Income:
Income
12
Financial Institution(s):
13
1lehlcle s :
Year, Make and Model:
State of Registration:
Bank Accounts:
Account Number(s):
Financial Institution(s):
Insurance policies:
Account Numb
Financial
Beneficiary:
14
Other Significant Assets ()lease descrlbe)-
iabilitles
! scribe nature and extent:
Hasa Will-been complete d?• / yes No
If yes, Executor's N
Executor's
15
S. Receipt of Income' Representative Payee. Many Residents find
security in appointing SHIPPENSBURG as the "Payee" or "Representative
Payee" of the Resident's income, Including social security income, By
appointing SHIPPENSBURG as the "payee" or the "Representative Payee", the
Resident directs that his or her income be directed to SHIPPENSBURG for the
purposes of paying for the Resident's care and services. Any excess funds
accumulated are refunded to the Resident or the Resident's Legal
Representative on or before the tenth (10) day of the month following the
receipt of the benefits. This is not required. However, if the Resident is
interested in appointina SHIPPENSRi?ar; - ?I-, .._
or the
Admfnlstrator's designee. SHIPPENSBURG~will assist your n?nmak g th
ese
arrangements.
6. PRIVATE RESIDENTS: A Resident is considered private (or private pay)
when no state or federal program is paying for the Resident's room and board.
A private=pay Resident may have private insurance or another third party, which
pays all or some of his or her charges.
a.) Dally Rate. The Resident agrees to pay SHIPPENSBURG's private
pay per diem rate as described in the Rate Schedule. The Resident agrees to
pay SHIPPENSBURG in advance for one month's private daily rate. For each
additional month's stay, the Resident agrees to pay SHIPPENSBURG fn
advance on or before the tenth (101h) day of the month. Any un? advance
payment shall be refunded to the Resident ninety (90) days after the Resident's
discharge If the Resident becomes covered by Medicaid or Medicare, or leaves
SHIPPENSBURG before the end of the month.
b.) Rate Adjustments. SHIPPENSBURG may occasionally need to
increase the daily rate or optional service charges. If this happens, the
Resident shall receive thirty (30) days advance written notice of the rate
adjustment. SHIPPENSBURG shall provide notice to the Resident, and if
known, the Resident's Legal Representative. When a notice of a rate
adjustment is wefved, the Resident can choose to end this Agreement by
providing written notice to the Administrator. If the Resident falls to leave
SHIPPENSBURG prior to the effective date of the rate adjustment, the Resident
shall be considered to have consented to the increase.
16
c.) Private Insurance. Even when there is private insurance coverage,
the si % amain rImarll res onsi to for a in all of SHIf'IPENS$URG's
char_aes. Where the Resident's private insurer is a managed care plan with
which SHIPPENSBURG has a contract, SHIPPENSBURG agrees to invoice the
managed care plan directly for the Resident's care and services. However, all
charges that are not covered by the managed care plan are the responsibility of
the Resident. These non-covered charges include but are not limited to any
coinsurance and/or deductible amounts which the managed care plan requires
the Resident to pay, to the extent allowed under federal and state laws. Where
the Resident's private insurer is not a managed care plan with which
SHIPPENSBURG has a contract, SHIPPENSBURG will invoice the Resident,
who is primarily responsible for payment of the invoice.
7. MEDICAL ASSISTANCE ?MED ID) RE11DENTS. A Medicaid Resident Is
one who receives benefits from the state Medicaid program for all or a majority
of his or her room and board charges. The services currently covered by
Medicaid are set forth in the attached Rate Schedule, which is subject to
change. SHIPPENSBURG makes no guarantee of any kind that the
Resident's care will be covered by Medicare, Medicaid, or any third party
insurance or other reimbursement source. SHIPPENSBURG, its agents
and associates are hereby released from any liability for the Resident's
potential claim for any failure to obtain such coverage.
With respect to applying for and receiving Medical Assistance through the
Medicaid Program, SHIPPENSBURG will assist the Resident in the application
process. The Resident agrees to the following:
a.) Qualifying for Medicaid Assistance. If the Resident elects coverage
under the Medicaid Program, the Resident agrees to act as quickly as possible
to establish and maintain eligibility for Medicaid. These actions must include,
but are not limited to, taking any and all steps necessary to ensure that the
Resident's assets and income are within the required limits and that these
assets and income remain within allowable limits for Medicaid.
17
b.) Providing Application Information, The Resident agrees to provide
Al financial and other information required for completion of the Medicaid
application accurately and truthfully, as requested by applicable state%ounty
agencies. Additionally, the Resident agrees to provide this information in the.
manner requested by the applicable agencies, and in compliance with any
deadlines set by the applicable agencies. Furthermore, the Resident agrees to
attend any and all interviews necessary for completion of the Medical
Assistance eligibility process, as requested by the applicable state/county
agencies. Failure to provide all financial and other information required for
completion and support of the Medicaid application accurately and truthfully, as
requested by applicable state/county agencies, may result in personal liability
for SHIPPENSBURG's charges.
c.) Keeping SHIPPENSBURG Informed. The Resident agrees to keep
SHIPPENSBURG informed of the status and progress of the Medicaid
application. The Resident agrees to provide SHIPPENSBURG with copies of
any financial and other information related to the Medicaid application, Including
a copy of the completed application.
d.) Transferring Assets. If the Resident transfers assets, this transfer may
disqualify the Resident for Medicaid and/or cause a discontinuance of the
Resident's Medicaid benefits. The Resident acknowledges that this may result
in discharge of the Resident due to non-payment, and personal liability for
SHIPPENSBURG's charges.
e.) Legal Representative Controlling Resident's Funds, If the
Resident's Legal Representative has control of or access to the Resident's
income and/or assets, the Legal Representative agrees to use these funds
solely for the Resident's welfare, This includes, but is not limited to, making
prompt payment for care and services provided to the Resident as specified
and required by the terms of this Agreement. Failure to use these funds solely
for the Resident's welfare may result in personal liability for SHiPPENSBURG's
charges.
t:) Providing Financial Information. The Resident certifies that any
financial information regarding the Resident's income and assets required by
SHIPPENSBURG and provided by the Resident is complete and accurate.
g.) Daily Rate Payment. The Resident agrees to pay the costs or
SHIPPENSBURG's per diem rate as described in the Rate Schedule.
18
h.) Termination or Denial of Coverage. The Resident may remain in
SHIPPENSBURG for as long as he or she is certified eligible for Medicaid
coverage, or for as long as any share of cost owed by the Resident Is paid as
due. A Resident who remains in SHIPPENSBURG after Medicaid coverage
has been denied and a final determination has been made must pay
SHIPPENSBURG charges as a private resident. In this event, the Resident will
pay based on. the private rates, charges, and terms in effect at the time of
service. Where the Resident falls to pay the private rates and charges, the
Resident agrees to seek immediate placement at an alternate facility at the
earliest possible time. Residents who have not already been determined
,mJ;^#hlu fnr A/?nrlin?id rr ___'_-----
--- - ---•_.......... ......vnao to
pending_ final determination of at least their monthiv Income (e a Social
Security, ension) less the amount established by law for the Resident personal
Funds_ Allowance (the current amount Is listed on the attached Rate Sc? hedule
Any refunds due to the Resident after the final determination of Medicaid
id
coverage wI11 be -made W thin ten t10? business days of SHiPPENSBUR
receipt of notice of such coverage
i.) Resident's Share of Cost. The Medicaid program reviews the available
monthly income of all persons requesting Medicaid. Based on this review, the
Medicaid program requires most Medicaid residents to pay for a reasonable
share of the cost of their care. The amount of the Resident's share of the cost
of their care can change based upon the services the Resident chooses, and
the Medicaid program can adjust the amount of the Resident's share of the cost
bf their care based upon changes in the Resident's income. Payment of that
share is the responsibility of the Resident.
J.) Appeal of Finding of Ineligibility. Where the Resident applies for
Medical Assistance benefits, the applicable state/county agency may deny or
limit benefits. While Resident retains all legal responsibility for obtaining his or
her benefits, Resident authorizes SHIPPENSBURG to assist Resident in
making any claims and to take all other actions necessary to secure the
Resident's benefits, including, but not limited to, assisting the Resident in
appealing any state/county agency determination and requesting Interim
Assistance benefits. The Resident agrees to provide SHIPPENSBURG with all
information related to obtaining benefits upon receipt, including, but not limited
to, notices of denial. ' This paragraph shall not create any responsibility on
behalf of SHIPPENSBURG to obtain benefits or any portion of benefits, nor any
liability for failure to obtain same. To facilitate this authorization, but not in lieu
thereof, the Resident agrees to properly execute the AUTHORIZATION FOR
REPRESENTATION - MEDICAID statement attached to this Agreement.
19
8. MEDICARE RESIDENTS: A Medicare Resident is one who receives
benefits from the federal Medicare program for his or her SHIPPENSBURG
care. The services currently covered by Medicaid are set forth in the attached
Rate Schedule, which is subject to change. Some additional items and services
may be also covered by Medicare. SHIPPENSBURG makes no guarantee of
any kind that the Resident's care will be covered by Medicare, Medicaid,
or any third party Insurance or other reimbursement source.
SHIPPENSBURG, its agents and associates are hereby released from any
liability for the Resident's potential claim for any failure to obtain such coverage.
a.) Cdntinuing Payment of SHIPPENSBURG Charges Pending
Eligibility, Where the Resident is not currently covered by Medicare,
the Resident agrees that while coverage is being pursued the Resident
shall pay the private pay rate as a private pay resident as described
within this Agreement: If the Resident is unable to pay the private pay
rate, the Resident agrees to pay SHIPPENSBURG an amount that is at
least equal to the Resident's monthly income from all of the Resident's
income sources. This amount, minus any amount not covered by
Medicare, shall be refunded to the Resident within thirty (30) days of
payment by Medicare should the Resident be found eligible by Medicare,
Once the Resident is determined to be eligible for Medicare, the amount
of the Residents share of cost not covered by Medicare shall be paid to
SHIPPENSBURG on , or before the tenth (10`") day of each month.
Furthermore, the Resident shall immediately pay to SHIPPENSBURG any
amount the Resident Is In arrears. If payment of any outstanding amount
cannot be made immediately, the Resident shall immediately discuss same
with SHiPPENSBURG's Administrator or the Administrator's designee, and
shall make arrangements to bring his or her account into balance within the
shortest possible time,
b.) Daily Rate Payment. The Resident agrees to pay the costs of
SHIPPENSBURG's per diem rate as described in the Rate Schedule for those
supplies and services not paid for by the Medicare program,
c.) Coinsurance and Deductibles. The Resident is responsible for
payment of any Medicare coinsurance and/or deductibles that are not paid to
SHIPPENSBURG by the Medicaid program or private insurance.
d.) Limited Coverage. The Resident understands that Medicare coverage
is established by federal guidelines and not by SHIPPENSBURG. Medicare
coverage is limited in that only a specified level of care is covered for a
specified number of days (benefit period). If the Resident no longer meets
Medicare coverage criteria, coverage can be ended before the use of all allotted
days in the current benefit period.
20
e.) Expiration of Benefits, Prior to admission, the Resident must be able
to demonstrate the ability to pay SHIPPENSBURG (either privately or through
Medicaid) for services rendered after Medicare benefits expire. When Medicare
coverage expires, the Resident may remain in SHIPPENSBURG if private pay
or other payment arrangements have been made. If the Resident wishes to be
discharged from SHIPPENSBURG upon expiration of Medicare benefits, he or
she must so advise SHIPPENSBURG at.the time of the Resident's admission.
If the Resident intends to become private pay when Medicare benefits expire,
the Resident agrees to pay in advance for one month's private daily rate when
the Resident changes to private pay status. No advance payment is required
from Medicare Residents who are eligible for Medicaid coverage,
f.) Appeals of Denials of Coverage. Where the Resident 'appifes for
Medicare benefits, the applicable intermediary, carrier or government agency
may deny the Resident these benefits or some portion of these benefits. Where
a denial occurs, the Resident retains all responsibility for obtaining his or her
benefits. However, the Resident authorizes SHIPPENSBURG to assist the
Resident in making all claims and to taking all other actions necessary to
secure his or her benefits, including, but not limited to, appealing any initial or
subsequent adverse determinations, including requests for Reconsideration.
The Resident agrees to provide SHIPPENSBURG with all information related to
obtaining benefits upon receipt, including, but not limited to, notices of denial.
This paragraph does not apply to benefits for which SHIPPENSBURG has
determined the Resident is not eligible, and does not affect the Resident's right
to have a Demand Bill filed. This paragraph shall not create any responsibility
on behalf of SHIPPENSBURG to obtain any portion of benefits, nor any liability
for failure to obtain same. To facilitate this authorization, but not in lieu thereof,
the Resident hereby agrees to property execute the AUTHORIZATION FOR
REPRESENTATION -- MEDICARE statement attached to this Agreement.
9, MANAGED CARE 0R ANV TIONS: Where the Resident enrolls in or
switches the Resident's enrollment to any managed care. organization
(hereafter "MCO"), including MCOs that provide Medicare or Medicaid benefits,
the Resident agrees as follows:
a.) The Resident shall advise SHIPPENSBURG prior to enrolling in or
switching the Resident's enrollment to any MCO,
b.) The Resident acknowledges that SHIPPENSBURG is not responsible
for and has made no representations regarding the actions or decisions of any
MCO with- which SHIPPENSBURG is a participating provider, including
decisions relating to a denial of coverage.
21
c.) SHIPPENSBURG will accept payment from the MCO as payment In
full only for those services and supplies covered by the MCO. The Resident is
responsible for any co-payments or other costs assigned to the Resident under
the managed care plan, or not covered by the MCO under the terms of the
managed care plan. If the Resident utilizes services which the MCO refuses to
pre-authorize, the Resident shall pay SHIPPENSBURG for those services.
Further, the Resident shall pay SHIPPENSBURG for services for which the
MCO has denied payment because the Resident failed to supply Information to
the MCO, or for services which are denied subsequently by the MCO.
d.) SHIPPENSBURG reserves the right to withdraw as a participating
provider in any MCO at any time and for any reason. In the event that
SHIPPENSBURG withdraws as a participating provider, the Resident may
convert his or her coverage to a health plan in which SHIPPENSBURG is a
participating provider. Effective the date of SHIPPENSBURG's withdrawal from
the Resident's MCO, the Resident is obligated to pay for services and supplies
provided to the Resident as a private pay resident. If possible,
SHIPPENSBURG will provide the Resident with advance written notice of its
withdrawal from the Resident's MCO thirty (30) days before SHIPPENSBURG's
withdrawal.
10. ASSIGNMENT OF THIRD PARTY PAYMENTS: The Resident irrevocably
authorizes SHIPPENSBURG to make claims and to take all other actions to
secure receipt of third party payments to reimburse SHIPPENSBURG for its
charges. To the fullest extent permitted by law, and as security for payment of
SHIPPENSBURG's charges, the Resident hereby assigns to SHIPPENSBURG
all of the Resident's rights to any third party payments now or subsequently
payable to the extent 'of all charges due under this Agreement. Resident shall
promptly endorse and deliver to SHIPPENSBURG any payments received from
third parties to the extent necessary to satisfy the charges under this
Agreement. To facilitate this assignment, but not in lieu thereof, the Resident
hereby agrees to properly execute the ASSIGNMENT OF THIRD PAkTY
PAYMENTS statement attached to this Agreement.
11. FINANCIAL POWER OF ATTORNEY: The Resident agrees that upon
admission the Resident, if able, will supply SHIPPENSBURG with a fully
executed and legally valid original Financial Power of Attorney appointing an
individual chosen at the Resident's sole discretion to be his financial attorney-
in-fact should the Resident become medically incompetent. If not able, the
Resident agrees to work with SHIPPENSBURG to pursue guardianship. This
Power of Attorney- need only become effective if the Resident becomes
medically incompetent. If, in the judgment of the Resident, no such individual is
available, the Resident agrees to appoint such an individual when one becomes
available. Judgment of the Resident's incompetence shall not require a court
22
adjudication, but shall require the written order of Resident's physician plus
confirmation by a second examining physician. The Resident's financial
attorney-in-fact shall be granted the authority to make financial decisions for the
Resident, including the unlimited power to pay SHIPPENSBURG's charges and
invoices from the Resident's income, and from the proceeds of the attorney-in-
fact's sale of the Resident's assets.
The selection of this attorney-in-fact serves at the complete discretion of
the Resident. However, should the Resident revoke the power of his or her
appointed attorney-in-fact, or should the Power of Attorney become inoperable
for any reason, the Resident hereby agrees to tmmedleteiy appoint a successor
attorney-in-fact for the financial purposes set forth herein, if such an individual is
available. Upon receiving a duly executed copy or facsimile of this Agreement
noting the Resident's appointed financial attorney-In-fact, SHIPPENSBURG
may act hereunder. Revocation of the attorney-in-fact shall be ineffective as to
SHIPPENSBURG unless and until written or actual notice or knowledge of such
revocation is received. The attorney-in-fact's power shall continue in full force
and effect and may be relied upon by SHIPPENSBURG despite purported
revocation until written notice of revocation is received by SHIPPENSBURG.
Residents should first consult with his or her family and attorney
before executing any Financial Power of Attorney form.
VI. PAYMENT INFORMATION'
A. DUE DATES -AND THE OBLIGATION OF TIMELY PAYMENT:
SHIPPENSBURG's charges for services provided shall be billed on a monthly
basis to the Resident. These charges are due and payable by the tenth (1o)
day of each month. If payment is not received by the fifteenth (15t) day of each
month, the account balance Is considered past due, and SHIPPENSBURG may
add late charges to the Resident's account. These late charges shall be
assessed on the monthly balance at the lesser of the monthly rate of 1.5% (one
and one-half percent) or the maximum amount permitted by law. This late
.charge does not alter any obligations of SHIPPENSBURG or Resident under
this Agreement.
The Resident recognizes that SHIPPENSBURG does not offer credit or
accept installment payments. SHIPPENSBURG's acceptance of a partial
payment does not limit SHIPPENSBURG's rights under this Agreement to full
payment for the care and services provided.
23
S. BILLING AMA ESS: All of SHIPPENSBURG's Invoices are to be mailed to
the following address for prompt payment (either Resident's address or Legal
Representative's address, when applicable):
C. FAILURE TO PAY AND DEFAULT OF AGREEMENT: SHIPPENSBURG's
due date for its payments falls on the fifteenth (15th) day of each month,
Resident's failure to remit a required payment within twenty-one,(21) days of
the due date constitutes DEFAULT of this Agreement, and SHIPPENSBURG
may require the Resident to vacate SHIPPENSBURG after appropriate
advance notice. If the Resident Is required to vacate SHIPPENSBURG for
failure to pay, SHIPPENSBURG shall provide advance notice as set forth in
Termination section of this Agreement. SHIPPENSBURG retains the right
under federal law and social security regulations to request the regional social
security field office to change the name of Representative in the event of
DEr-AULT of this Agreement or the Representative Payee is consistently late
with payments.
24
O. VENUE. It Is hereby agreed that this Admission Agreement is a
transaction entered Into and accepted by the parties herein at the offices
of SHIPPENSBURG, in Cumberland County, Pennsylvania. Resident
agrees that, In event of DEFAULT, SHIPPENSBURG may bring a civil
action In the Court of Common Pleas of Cumberland County,
Pennsylvania, to collect any amounts owed to SHIPPENSBURG under the
terms of this Agreement.
E. ATTORNEY'S FEES AND COSTS OF COLLECTION: In the event that
SHIPPENSBURG Institutes and is a prevailing party in iiflgation in court against
any party to this Agreement arising from DEFAULT or other non-payment under
Agreement, SHIPPENSBURG shall be entitled to receive from the losing party
reasonable attorneys' fees and costs of collection.
F. FEg FOR RETURNED CHECKS: A service fee of $25.00 (twenty-five
dollars) or the actual fee charge"; the bank, whichever is greater, will be
charged for any returned check.
G. OBLIGATIONS OF RESIDENT'S ESTATE AND ASSlGNMEN7 Q?
PROPERTY: This Agreement shall operate as an assignment, transfer and
conveyance to -SHIPPENSBURG of as much of the Resident's property as is
equal in value to the amount of any unpaid obligations under this Agreement,
and this assignment shall be an obligation of the Resident's estate and may be
enforced against the Resident's estate. The Resident's estate shall be liable to
and shall pay SHIPPENSBURG an amount equivalent to any unpaid obligations
of the Resident under this Agreement. This assignment shall apply whether or
not the Resident is residing in SHIPPENSBURG at the time of the Resident's
death.
25
VII. 8ED HOLDS
A. OTICE. The Resident may need to be absent from SHIPPENSBURG
temporarily for hospitalization or therapeutic leave. The Resident may request
that SHIPPENSBURG hold open the Resident's bed during this time. This is
known as a "bed hold." The Resident, and if known, the Resident's Legal
Representative shall be given notice of the bed hold option at the time of
hospitalization or therapeutic leave. A schedule of charges for bed holds is
located on the Rate Schedule attached to this Agreement.
B. MEDICAID RESIDENTS If the Resident's care is paid under the
Medicaid Program, Medicaid currently pays for up to 15 consecutive bed hold
days for each hospitalization and for up to 30 bed hold days each year for
therapeutic leave. If the Medicaid Resident's hospitalization or therapeutic
leave exceeds the bed-hold period paid under the Medicaid program, the
Resident may request an additional bed hold period from SHIPPENSBURG by
agreeing to pay the daily additional bed hold amount listed in the attache Rate
Schedule. Otherwise, the Resident shall be readmitted upon the first availability
of a bed in a non-private room as long as the Resident requires the services
provided by SHIPPENSBURG and Is eligible for Medicaid benefits,
C. PRIVATE AND MEDICARE RESIDENTS: Any Private or Medicare
Resident may request a bed hold from SHIPPENSBURG. The Resident's
private insurance may or may not pay for bed holds. The Medicare program
does not pay for bed holds. 'However, if the Medicare Resident is also eligible
for Medicaid, and if proven to the satisfaction of SHIPPENSBURG, Medicaid
pays for 15 bed hold days. Otherwise, a Private or Medicare Resident
requesting a bed hold must pay SHIPPENSBURG's bed hold rate set forth in
the Rate Schedule for the bed being held during the bed hold period.
,_L"
26
Vill. PERSONAL FUNDS
A. RESIDENT FUND AUTHORIZATION. The Resident has a right to
manage his or her own personal funds. If the Resident wants assistance with
management of personal funds, and requests so in writing through a Resident
Fund Authorization form, SHIPPENSBURG will hold, safeguard, manage, and
account for these funds. A Resident Fund Authorization form can be obtained
from SHIPPEi\ISBURG's Administrator or designee.
B. PROCEDURES. Resident personal funds deposited with
SHIPPENSBURG shall be handled as follows:
9. SHIPPENSBURG shall deposit funds in excess of fifty dollars ($50.00) in
an interest-bearing account insured by the Federal Deposit Insurance
Corporation (FDIC) that is separate from any SHIPPENSBURG operating
accounts. All interest eamed on the Resident's funds shall be credited to his
or her account. SHIPPENSBURG shall have the option of depositing funds
of less than fifty dollars in a non-interest bearing account, an interest bearing
account, or a petty cash fund. SHIPPENSBURG shall inform the Resident
as to how his or her funds are being held. SHIPPENSBURG's policy is to
maintain all resident funds in a separate account, except for a nominal
amount maintained In a petty cash fund for the Resident's convenience.
2. SHIPPENSBURG shall have a system that ensures a complete and
separate accounting, based on generally accepted accounting principles, of
the personal funds deposited with SHIPPENSBURG by each Resident or on
his or her behalf. This system shall also ensure that the Resident's funds
are not commingled with SHIPPENSBURG's funds or with any other funds
besides those of other residents. In addition to the required quarterly
accounting, SHIPPENSBURG shall provide individual financial records at
the-written request of the Resident.
3. The personal fund balance a resident receiving Medicaid benefits must
remain within a certain dollar range for the Resident to continue to receive
benefits. SHIPPENSBURG shall notify a Medicaid resident if his or her
account balance Is within two hundred dollars ($200.00) of the federal
Supplemental Security income (hereafter "SSI") limit. SHIPPENSBURG
shall also notify the Resident if the account balance, in addition to the
Resident's known non-exempt assets, reaches the SSI resource limit.
Furthermore, SHIPPENSBURG shall notify the Resident if the account
balance, in addition to the Resident's known non-exempt assets, reaches
the resource limits for Medicaid eligibility. A balance in excess of this limit
may cause the Resident to lose eligibility for Medicaid or SSI.
4. If a Resident who has personal funds deposited with SHIPPENSBURG
expires, SHIPPENSBURG shall refund the Resident's personal account
27
X. TERMINATION OF AGREEMENT
A. RIGHT TO 7'ER 'IIVATE: An explanation of the Resident's rights
concerning termination, transfer, and discharge is contained in the Statement of
Resident Rights, which is attached to but separate from this Agreement.
B. RESIDENT INITIATED: Notice of resident initiated termination is
required for proper discharge planning. Other than in the case of a medical
emergency or death, the Resident will provide SHIPPENSBURG with written
notice two (2) business days before the Resident's termination of this
Agreement.
C. REFUNbS: If a Resident has personal funds deposited with
SHIPPENSBURG upon termination of this Agreement, SHIPPENSBURG shall
refund the Resident's personal account balance within thirty (30) days, and
provide the Resident or the Resident's estate with a full accounting of these
funds. However, any outstanding balance owed to SHIPPENSBURG for the
Resident's care and services shall first be deducted from the Resident's
personal account as permitted by law.
Xi. RESIDENT GRIEVANCE! COMPLAINT RESOLUTION
A. RESIDENT GRIEVANCES:
1.) All Residents, family members, and Resident representatives are
urged to bring any grievances concerning SHIPPENSBURG to the
attention of the SHIPPENSBURG Administrator or the Administrator's
designee.
2.) In addition to bringing grievances to the attention of
SHIPPENSBURG Administrator or designee, residents may also contact
the outside representative of his or her choice. Outside representatives
include the Governor's Action Line at (800) 932-0784, the Department of
Health Hot Line at (800) 2646154, the Long Term Care Ombudsman
located within the Local Area Agency on Aging, and the Legal Services
Program. The telephone number of the local Long Term Care
Ombudsman and the Legal Services Program is located within the
Resident's Bill of Rights accompanying this Agreement.
29
®. ARBITRATION OF NONPAYMENT DISPUTES UNDER THIS
AGREEMENT
(a) UNLESS OTHERWISE MUTUALLY AGREED UPON IN WRITING,
SHOULD GRIEVANCE PROCEDURES FAIL,' THE RESIDENT AND
SHIPPENSBURG AGREE THAT ALL DISPUTES ARISING UNDER.
THIS AGREEMENT, WITH THE EXCEPTION OF DISPUTES
CONCERNING DEFAULT (AS DEFINED ABOVE IN SECTION VI-C)
OR OTHER NON-PAYMENT FOR SERVICES RENDERED, SHALL BE
RESOLVED BY BINDING ARBITRATION BEFORE A NEUTRAL
ARBITRATOR, ASSIGNED TO THE MATTER IN ACCORDANCE WITH
THE AMERICAN HEALTH LAWYERS ASSOCIATION (AHLA)
ALTERNATIVE DISPUTE RESOLUTION SERVICE RULES OF
PROCEDURE FOR ARBITRATION.
(b) SUCH ARBITRATION SHALL TAKE PLACE AT SHIPPENSBURG
AT A MUTUALLY AGREED UPON TIME. ANY TIME A DISPUTE
ARISES, ANY PARTY MAY REQUEST THE APPOINTMENT OF AN
ARBITRATOR TO RESOLVE THE DISPUTE.
(a) THE REQUESTING PARTY SHALL NOTIFY THE OTHER PARTY
IN WRITING A MINIMUM OF SEVEN (7) BUSINESS DAYS PRIOR TO
REQUESTING THE APPOINTMENT OF THE ARBITRATOR.
('d) THE COSTS OF THE ARBITRATOR AND ALL COSTS
ASSOCIATED WITH THE ARBITRATION, INCLUDING ATTORNEY'S
FEES, COSTS, AND EXPENSES SHALL BE BORNE BY THE LOSING
PARTY.
(e) THE DECISION OF THE ARBITRATOR WILL BE FINAL AND
BINDING, AND MAY BE ENTERED AS A JUDGMENT IN ANY COURT
HAVING COMPETENT JURISDICTION.
30
Xil. MISCELLANEOUS PROVISIONS
A. CLINICAL/ FINANCIAL INFORMATION: With and at
SHIPPENSBURG's discretion, the Resident hereby authorizes
SHIPPENSBURG to obtain all of the necessary clinical and/or financial
documentation from the Resident prior or transferring hospital or nursing facility.
B. SOLE AGREEMENT: This Agreement, along with any documents
attached or included by reference, is the only agreement between
SHIPPENSBURG and parties. Changes to this Agreement are valid only if
made in writing and signed by all parties. If changes in state or federal law
make any part of this Agreement invalid, the remaining terms remain valid and
enforceable.
C. NON-ASSIGNABLE AGREEMENT: The Resident agrees that the right
of the Resident to reside at SHIPPENSBURG is personal and not assignable.
The Resident may not transfer his or her rights under this Agreement to any
other person.
0. GOVERNING LAW: This Agreement shall be governed by and construed
by the laws of the Commonwealth of Pennsylvania, and shall be binding upon
and shall be for the benefit of each of the undersigned parties and their
respective heirs, personal representatives, successors and assigns.
E. SEVERABiLITY: The Resident and SHIPPENSBURG agree that each
separate obligation contained in this Agreement shall be deemed a separate
and independent agreement. If any term, condition, clause or provision of this
Agreement shalt be determined or declared to be void or invalid in law or
otherwise, then only that term, condition, clause or provision shall be stricken
from this Agreement, and in all other respects this Agreement shall be valid and
continue in full force, effect and operation.
F. CAPTIONS: The captions used in this Agreement are inserted only for
the purpose of reference. Such captions shall not be deemed to govern, limit,
modify or In any manner affect the scope, meaning or intent of the provisions of
this Agreement., The captions shall be given no legal effect.
G. WAIVER: A waiver by either party at any time of any of the terms,
conditions, or covenants of this Agreement, or of any default or breach shall not
be deemed or taken as a waiver at any time thereafter of the same or any other
term, condition or covenant herein contained, nor of the strict and prompt
performance thereof.
31
H. MODIFICATIONS: SHIPPENSBURG reserves the right to unilaterally
modify this Agreement to the extent necessary to conform the Agreement with
subsequent changes in law or regulation. SHIPPENSBURG will notify the
Resident thirty days (30) before such modification, if possible.
X111, ACKNOWLEDGMENTS
A. RATE SCHEDULE: The Resident and the Resident's Legal Representative
hereby acknowledge the receipt of a copy of the Rate Schedule and sufficient
opportunity to ask questions about the Rate Schedule to answer all of their
questions about SHIPPENSBURG's charges. The Resident and the Legal
Representative hereby acknowledge that SHIPPENSBURG can and will alter
the Rate Schedule from time to time, and that Resident will be subject to those
changes. The Resident and the Resident's Legal Representative hereby agree
to be subject to those changes as provided in this Agreement.
G. STATEMENT OF RESIDENT'S RIGHTS: The Resident and the Resident's
Legal Representative hereby acknowledge being informed orally and of
receiving a written copy of the Resident's Rights, as set forth in this Agreement,
and as further set forth in the accompanying SHIPPENSBURG's Statement of
Resident's Rights. Furthermore, the Resident and the Resident's Legal
Representative hereby acknowledge having sufficient opportunity to ask
questions about the Resident's rights and have received appropriate responses.
The Resident and the Resident's Legal Representative hereby acknowledge
that the accompanying Statement of Resident's Rights is subject to change
from time to time, and shall not be construed as imposing any contractual
obligations on SHIPPENSBURG or granting any contractual rights to the
Resident.
C. COMMONWEALTH'S ADMISSIONS NOTICE PACKET: The Resident and
the Resident's Legal Representative hereby acknowledge being informed orally
and of receiving a written copy of the Commonwealth's Admissions Notice
Packet, accompanying this Agreement. Furthermore, the Resident and the
Res[dent's Legal Representative hereby acknowledge having sufficient
opportunity to ask questions about the Resident's rights and have received
appropriate responses. The Resident and the Resident's Legal Representative
hereby acknowledge that the Commonwealth's Admissions Notice Packet is
subject to change from time to time, and shalt not be construed as imposing any
contractual obligations on SHIPPENSBURG or granting any contractual rights
to the Resident.
32
0.
11.11L] zt!"WEC KtUUR The
and the Resident's Legal Representative h
ereby acknowledge being iinnformed
orally of and receiving a written copy of the Privacy Act Statement •- Health
Care Records, in compliance with the Privacy Act of 9974. Furthermore, the
Resident and the Resident's Legal Representative hereby acknowledge having
sufficient opportunity to ask questions about the Privacy Act Statement and
have received appropriate responses.
E. HEALTH CARE ADVA CE DIRECTIVES: The Resident and the Resident's
Legal Representative hereby acknowledge being informed orally and In writing
about health care advance directives, including receiving a copy of the
Commonwealth's Medical and Treatment Self-Directive Statement, and of
SHIPPENSBURG's policy concerning health care advance directives and
medical treatment decisions. Furthermore, the Resident and the Resident's
Legal Representative hereby acknowledge having sufficient opportunity to ask
questions about advance directives, the Commonwealth's Medical and
Treatment Self-Directive Statement, and SHIPPENSBURG's policy thereon,
and have received appropriate responses to all of their questions.
F. STATEMENT OF PRIVACY PRACTICES: The Resident and the Resident's
Legal Representative hereby acknowledge having been informed orally of and
receiving a written copy of SHIPPENSBURG's Statement of Privacy Practices,
in compliance with the Health Insurance Portability and Accountability Act of
9996 (HIPAA). Furthermore, the Resident and the Resident's Legal
Representative hereby acknowledge having sufficient opportunity to ask
questions about the Statement and have received appropriate responses.
G. AGREEMENT: The Resident and the Resident's Legal Representative
hereby acknowledge that they have carefully read and understand the terms of
this Agreement; and that the terms have been explained to them by a
representative of SHiPPENSBURG. Furthermore, the Resident and the
Resident's Legal Representative hereby acknowledge having sufficient
opportunity to ask . questions about the Agreement and have received
appropriate responses.
33
IN WITNESS. WHEREOF, INTENDING TO BE LEGALLY BOUND, the
parties hereto have executed this Agreement the day of
and same shall be
considered binding upon all parties, and shall remain in full force and effect
unless and until cancelled according to the terms of this Agreement.
Resident
Date
Lega Representativ
t
SHl -NSBUR e p atEVe
Witness
Witness
Date
Date
Date
Date
34
MAGNOLIA MANAGEMENT INC
1710 Underpass way, Suite 201
Hagerstown, MO 21740
301.745.8700, ext. 1245
Shippesburg Heatth Care Center
T6: Ruth Martin
C/0 Carolyn Martin
342 Wayne Ave.
Chamb&sburg, PA 17201
INVOICE
3/29/2011
For: Ruth Martin
Page 1
EXHIBIT "B"
PERINI SERVICES/ IN THE COURT OF COMMON PLEAS OF
SOUTH HAMPTON MANOR, L.P. : CUMBERLAND COUNTY, PENNSYLVANIA
Plaintiff :
v. NO. 2011- 4127 CIVIL TERM
CAROLYN D. MARTIN,
Individually and as agent
for Ruth V. Martin
Defendant
TO THE PROTHONOTARY:
•
PRAECIPE TO DISCONTINUE
C=a
-C-
rn
D
Kindly mark the above -captioned action as satisfied and discontinued without prejudice.
Date: September 4, 2014
Respectfully submitted,
BARIC SCHERER LLC
David A. Baric, Esquire
I.D. # 44853
19 West South Street
Carlisle, PA 17013
(717) 249-6873
Attorney for Plaintiff
CERTIFICATE OF SERVICE
I hereby certify that on September 4, 2014, I, David A. Baric, Esquire of Baric Scherer
LLC, did serve a copy of the Praecipe To Discontinue, by first class U.S. mail, postage prepaid,
to the party listed below, as follows:
William S. Dick, Esquire
13 W. Main Street, Suite 210
Waynesboro, Pennsylvania 17268
David A. Baric, Esquire